130 H. Khajmi et al.: Radioprotection 2026, 61( 2), 126 – 131
The typical value of the entrance surface dose presented here for the shoulder AP projection of 1.25 mGy is well above the statistics of other studies. This demonstrates that higher exposure parameters are used for this radiography because of the greater thickness in this part of the body. The TDRL value of this work based on ESD for knee AP projection is 0.58 mGy. This is higher than the DRL values for the EC( 0.4 mGy), the UK( 0.3 mGy), and Nigeria( 0.5 mGy). Whereas, expect DRL in the UK during 2016 for knee LAT projection; the median value of ESD is lower. Regarding skull AP / LAT, the DRL values of 2.2 mGy / 2.1 mGy were higher than those published in the other countries, with the exception of France’ s 2013 estimate of 3 mGy / 5 mGy and Iran’ s 2022 value of 2.2 mGy / 2.4 mGy. For chest X-ray PA projection, the TDRL in this study was found to be 0.22 mGy higher than that seen in the UK( 0.15 mGy) but less than those registered in France( 0.3 mGy), EC( 0.3 mGy), Nigeria( 0.59 mGy), Iran( 1.4 mGy), and Ghana( 0.3 mGy).
Table 3 shows that there are differences between our study’ s TDRLs and those of official organizations( EC, 2014) and the other reporting nations. The variations in dosage between the research centers are consistent with the results of Shrimpton et al.( 1986), who revealed that disparities between the centers might reach up to 10 to 40 in the UK and 8 to 20 in Norway. The radiography technology system may be responsible for these variances. Different DRLs in such an inter-survey comparison will result from a range of causes, including statistical variances, measuring techniques, clinical approaches, and equipment. For example, the French( Roch et al., 2013) and UK( UK, 2016) surveys during 2013 and 2016 selected patient dosage data from a large number of institutions of different sizes. Besides, a very large number of hospital radiological examination doses were also reviewed. In Nigeria( Joseph et al., 2017), the study was conducted in two university teaching hospitals, and 750 patients were assessed. While all 1170 radiographs in our investigation were conducted in a single digital radiography room with one X-ray machine.
5 Conclusion
This project developed typical DRLs values in terms of ESD for eight radiographic examinations at the Mohammed VI University Hospital Centre at the Arrazi Hospital in Marrakech, Morocco. An evaluation of local practices, taking into account operational procedures or equipment performance. The findings demonstrated that, with the exception of the TDRLs of the shoulder, knee, and skull radiographs, which were greater than those published elsewhere, most of the DRLs were lower than the suggested international DRLs.
In order to minimize the risk of stochastic effects associated with radiography, the X-ray department of the Arrazi Hospital requires a process of homogenization of radiation exposure to patients undergoing radiographic examinations, regular quality control of equipment, and a dose optimization strategy.
To establish a baseline, the information collected in this study can be compared to future dose assessments. Authorities at the national and professional levels might also find this dose survey helpful to develop the national DRLs for conventional radiography in Morocco.
Acknowledgments
The authors would like to express their gratitude to everyone who provided assistance throughout this study, particularly the radiography center for their cordial collaboration.
Funding The study’ s authors did not receive any funding for it.
Conflicts of interest There is no conflict of interest for this paper.
Data availability statement
The entire study results are available from H. KHAJMI, the corresponding author.
Author contribution statement
Each author contributed to the study’ s design and implementation, analysis of the results, and writing of the report.
Ethics approval Ethical approval was not required.
Informed consent This study did not require informed consent.
References
Alrehily F. 2022. Diagnostic reference levels of radiographic and ct examinations in Saudi Arabia: A systematic review. Radiat Prot Dosim 198( 19): 1451 – 1461. https:// doi. org / 10.1093 / rpd / ncac183.
Benamar M, et al. 2023. Patient dose assessment in computed tomography in a Moroccan imaging department. Radioprotection 58( 1): 49 – 53. https:// doi. org / 10.1051 / radiopro / 2022039.
Benmessaoud M, et al. 2021. Derivation of local diagnostic reference levels for common adult computed tomography examinations in Moroccan hospital. Radiat Prot Dosim 194( 4): 208 – 213. https:// doi. org / 10.1093 / rpd / ncab095.
Ciraj O, et al. 2005. A survey of patient doses from conventional diagnostic radiology examinations: first results from Serbia and Montenegro. Phys Med 21( 4): 159 – 163.
EC European Commission. 2014. Radiation Protection No. 180. https:// ec. europa. eu / energy / sites / ener / files / documents / RP180 % 20part2. pdf.
EUR96 European Guidelines on Quality Criteria for Diagnostic Radiographic Images, European Commission, EUR 16260 EN, June 1996.
El Mansouri M, et al. 2022. Establishing local diagnostic reference levels for adult computed tomography in Morocco. Radioprotection 57( 1): 61 – 66. https:// doi. org / 10.1051 / radiopro / 2021035.
European Commission. 1999. Radiation protection report 109. Guidance on diagnostic reference levels( DRLs) for medical exposures. European Commission, UK.